AMANDA M JOHNSON D.O.
NPI 1073046330
Family Medicine in Portland, OR
About Amanda M Johnson D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANDA M JOHNSON D.O. (NPI 1073046330) is an individual family medicine provider in Portland, Oregon, licensed in Oregon (DO222716) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, is affiliated with Providence Portland Medical Center, and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Amanda M Johnson D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Amanda Johnson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 676 clinicians in this Medicare group
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 1,501 clinicians in this Medicare group
Portland, OR 97225
- Reassigned Medicare billing, Oregon enrollment
- 753 clinicians in this Medicare group
Colorado Springs, CO 80917
- Reassigned Medicare billing, Colorado enrollment
- 355 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Providence Portland Medical Center
Acute Care Hospitals · Portland, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97213 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97213
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Amanda Johnson's NPI number?
The NPI number for Amanda Johnson is 1073046330. It was assigned to this individual provider in the NPPES registry on April 4, 2017. The provider is also known as Amanda Wilson Do.
Where is Amanda Johnson located?
Amanda Johnson practices at 4805 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 215-2392.
What is Amanda Johnson's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Amanda Johnson enrolled in Medicare?
Yes. Amanda Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Amanda Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Johnson reassigns Medicare benefits to 4 organizations: Providence Health & Services - Oregon (Portland, OR), Providence Health & Services - Oregon (Portland, OR), Providence Health & Services - Oregon (Portland, OR) and Peak Vista Community Health Centers (Colorado Springs, CO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Amanda Johnson affiliated with any hospitals?
According to CMS data, Amanda Johnson is affiliated with Providence Portland Medical Center.
When was this NPI record last updated?
The NPPES record for Amanda Johnson was last updated on February 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Amanda M Johnson, D.O. · NPI 1073046330
Family Medicine physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since April 4, 2017.
## Identity
- **NPI:** 1073046330 (Entity type: Individual)
- **Enumerated:** April 4, 2017
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** DO222716 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 4805 NE GLISAN ST, Portland, OR 97213-2933
- **Phone:** (503) 215-2392
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Providence Health & Services - Oregon (NPI 1003991845, Portland, OR); Providence Health & Services - Oregon (NPI 1316197692, Portland, OR); Providence Health & Services - Oregon (NPI 1235259532, Portland, OR); Peak Vista Community Health Centers (NPI 1730166034, Colorado Springs, CO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Lincoln Memorial University Medical Department, class of 2017
## Record status
- **NPPES last updated:** February 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1073046330) · Data from the CMS NPPES public registry.